Meeting Room Reservation Request Form

____________________________________________________________requests the use of (Name of Individual and/or Organization)

the Dale McConchie Meeting Room on ____________________________________________ (Day and Date)

for the hours of __________________________________. (Time)

Purpose/Type of Meeting/Event___________________________________________________

I accept responsibility for any damages that occur during this time reserved for me.

I have read and understand the attached Meeting Room Policy.

It is understood that the non-refundable rental fee and a security deposit (if a key is needed) must be paid upon completion of this request, which must be submitted a minimum of 24 hours prior to the requested date/time.

I understand that a security camera is located in the Meeting Room for the protection of our patrons and staff.